This chapter is about multiproblem families, their communication deficits, and
their difficulties with normative and nonnormative transitions. It is also about a
promising method of enabling multiproblem families to change.

MULTIPROBLEM FAMILIES AND TRANSITIONS

Consider Maria, a 27-year-old, bilingual, Hispanic mother and her two daughters,
Juanita, aged 7 and Dolores, 3. Dolores' father, a drug addict, drifts in and out of
the household. Violent arguments between the parents are frequent when he is at
home. Maria did not finish high school and has never been employed. As a
teenager she made several suicide attempts following episodes of sexual abuse by
her father. She suffers from Type 1 diabetes and has been hospitalized at least
yearly with episodes of major depressive disorder since age 20. Juanita has
diabetes and spina bifida and moves around with the help of a walker. She has been
subject to physical and sexual abuse and neglect by her mother and stepfather and
isolated from contact with peers. She has a sweet, sunny manner and wants very
much to please adults. Despite her obvious desire to please her teacher, her
academic achievement is considerably below her capabilities. Dolores is a healthy,
boisterous child who shows signs of language delay.

The family is supported by public assistance. For the last year, they have lived
in a new apartment for the handicapped. A van for the handicapped transports
Juanita to school and the whole family to the hospital for clinical visits. A
homemaker assists the mother on week-days, but funding for her services is
unlikely to continue. As a condition for retaining custody of her children, after

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